Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria
A literature review and meta-analysis of individual patient data
Abstract
Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. The 3 artemisini based combination therapies (ACTs) assessed in this analysis - artemether-lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine - continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.
Citation
WorldWide Antimalarial Resistance Network (WWARN) Artemisinin based Combination Therapy (ACT) Africa Baseline Study Group. (2015) Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: A literature review and meta-analysis of individual patient data. BMC Medicine 13:212 https://doi.org/10.1186/s12916-015-0445-x